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Simple Webform / Database Project

Simple Project: Webform / Database Creation

It needs to be two separate pages, all of the data should be stored in some sort of back-end database, maybe mySQL or some other option. The colors in my examples are not important. Needs to be HTML5 compatible. I have a Virtual Private Server with root access so we can pretty much do whatever method works best. I would like everything to look simple but function without alot of JavaScript, etc.

Page 1 is the actual webform itself as I have created a test example here of exactly what I need it to function like: [url removed, login to view]

Page 2 needs to be very similar to the attachment I have included [url removed, login to view]

I am not sure if a 3rd page is necessary, but I want to have the admin ability on Page 2 so that I can DELETE an entry entirely. If this is too difficult then I am sure I can sort through the database and delete it manually.

Page 1 Details:

***MUST BE MOBILE PHONE COMPATIBLE / DETECTABLE***

This will mostly be accessed from a mobile phone.

Every field must be a required field.

-Property Field [I need to have the ability to add or remove from this field]

-Address [Text field with no more than 30 characters]

-Date [Prefer a pop-up calendar, but having a separated Month, Day, Year list will work]

-Time [Must be a 4 digit number, numbers only]

-Report Type [Two options: Incident or Notification]

--IF INCIDENT then Arrest Made: Yes or No

--IF INCIDENT then Report Written: Yes or No

--IF INCIDENT then Case # [Max 9 characters, numbers only]

--IF INCIDENT then Suspects Name [Must have ability to add more than one person, would prefer a "+" symbol to add more names]

-Comments [Limit to 100 characters in length]

-Submitted by [Limit to 15 characters in length]

Page 2 Details:

This will mostly be accessed by a desktop computer.

Needs to be exactly what the attachment shows [[url removed, login to view]].

Must be able to sort by the property field only.

The top box at the far right will be a text field that someone would leave follow-up comments in, I want to limit the length of the textbox to 100 characters or less.

The bottom box at the far right side will be where the submitting person will type their name, limit this textbox to 20 characters.

ONCE A USER SUBMITS FOLLOW-UP, NO CHANGES SHOULD BE ALLOWED.

I WILL NOT PAY UNTIL THE VERY END, I HAVE BEEN RIPPED OFF TWICE & FROM MY FEEDBACK YOU CAN SEE I AM A VERY TRUSTED FREELANCER.

Thanks!

I want to add two additional requirements to my project:

1) When a form is submitted on Page 1, it sends an email notification that says a generic message like, "You have a new notification waiting at....." Each property would require its own email field. So depending on which property the incident occurred at, it could notify each manager separately.

2) Next to the submit button on Page 2, I would like a print icon that when someone clicks on it it will open in a new window so that they could just print out that specific incident for the users records.

Færdigheder: Elektroniske Formularer, HTML, MySQL, PHP, Web Design

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Om arbejdsgiveren:
( 33 bedømmelser ) Georgetown, United States

Projekt-ID: #6000972

Tildelt til:

techvolcano

Hi, We are experts in php/html5 and ready to start now. We can build the site with minimum javascript. Looking forward to hear from you. Thanks.

$120 USD in 3 dage
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20 freelancere byder i gennemsnit $174 for dette job

hits

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sonuinfy

Hey there! Certified PHP/HTML/Wordpress expert here with 6+ years of exp. I'm in Top 5 among 100,00000+ freelancers in [url removed, login to view] in these categories. You can verify the same here : [url removed, login to view] Mere

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scriptphp87

Hello, I am a professional programmer for web programming with php language to build the system website, Besides, I also expert in MySQL , HTML,HTML5,CSS, JS I'm always top in Vietnam freelancer [url removed, login to view] Mere

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Hi I work towards providing reliable, relevant and robust IT solutions at most competitive prices to my customers. I ensure 100% customer satisfaction so lets start Thanks

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vertexsolutions

I am the right programmer you are looking for. I have read the detail of the project. It will be done very nicely. Thanks

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breathhacker

Hey there, I can complete this in the next 1 hour. I will also add a small admin panel for you to delete records. The database would be in MySQL. Also, you do not need to make payment until you're satisfied. Mere

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sprextech

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NeverDream

Hello , I understand the project description. I have some questions I like to ask. 1. When someone filling the form, he/she doesnt have to put an email address ? 2. Can I use BOOTSTRAP framework for the respons Mere

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jmurphree

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peterkurt

Hi, if you are interested in my offer, please let me know if you want to implement to existing source code or I can make new application for it. I will need if the page 2 should be password protected and another det Mere

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unibit

Δεν έχει γίνει καμιά πρόταση ακόμα

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GauravRoy

Since all you need is a form with a database and its validation and some sorting using mysql on page2 .Also both the pages should be HTML5 compatible... I can do it for you as it is not very hard and won't be taking mu Mere

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villajohn

I can use a fully html 5 and responsive design to build the forms. I will include the calendar as a popup as you wish. Both forms may be mobile compatible if you want to use the form in the attachment in a mobile devic Mere

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sharif277

Hello there We would like to complete this project for you. We are expert on php programming. Detail of our experience would be found in [url removed, login to view] Please discuss with us in detail before a Mere

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SUstudios

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